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Wednesday, December 30, 2009

MiM Mailbag: Calling other/former resident moms

I would like to resolve to have one day of residency when I didn't wonder if I should quit and stay home with my son. And, once I've had that one day, I'd like to move on to more days than not...Any more experienced and wisers have advice for how to accomplish this?

How did others do it? Was/Is this a constant struggle? Any regrets?Does it get better?

16 comments:

I had my kids in fellowship (#1 and 2) and as an attending (#3). Having a kid in residency has to be so much harder. With both of my first two kids, I gave serious consideration on many occasions to leaving my fellowship and just practicing general internal medicine once they were a little older. For many reasons, I didn't. My kids are now 6, 4.5, and 2, and I have been working 3 days/wk since the middle one turned 1. As a doctor who is essentially a stay at home mom 4 days per week and a working mom 3 days per week, let me tell you plainly that it looks like sunshine and lollipops to be home when you are working, but it is hard. Really, really hard. And often it is frustrating. And the work never stops. And it is often thankless. And most of the day to day activity of your day is not what you envisioned when you signed up for this. All of the things you might feel about residency are true of being an at home parent, too. For me, working part-time has been the solution. It isn't just because I want to keep up my doctoring skills despite being an at home parent half the week. It is also because I would lose my mind if I had to do 7 days per week what I currently do for 4--take care of the kids! I don't know how old your son is, but if he is a baby or toddler, there will come a time not far in the future when you will be grateful to go to work! And medicine, in addition to all the warm and fuzzy reasons to choose it as a career, has the added advantage that it is a field In which you can make a decent living and have a satisfying career (not just a job) even working part-time. I would advise you to thinklong and hard about quitting your residency unless you hate the field you have chosen. You will have a lot of life left ahead of you once your kid is in school all day (kindergarten in many states), and it is important to have a career you love!

I had both kids in residency, and it was tough. I am still struggling, two plus years into a three-year to partner private practice job, to resolve many issues in my life that I simply ignored in order to keep going. Restoring my own mental health and happiness. I am much happier now. Still working on that.

Staying home for eight weeks for maternity leave (it was only six, but I orchestrated my way into eight since I started residency a month early - convinced the higher-ups I deserved it and could finish with all my requirements) made me realize, like Tempeh above, that staying home is just as tough, and, like she said, often thankless. I leaned a lot on a stay at home-mom down the street, a good friend then and now, for support, and realized that she had her ups and downs, just like me. There are pluses and minuses to any decision that you make.

I pushed through, and feel like it was worth it. I have a lot more free time now than I did in residency, a lot more vacation, and am slowly regaining a sense of control in my life and work. I'm glad I stuck it out. I think it worked for me. I am proud of my career, doing medicine, my performance, my relationship with my colleagues, and establishing a presence in a large hospital. Having relationships with clinicians that count on me. Having respect (of and from) and friendship with an enormous population of lab technicians, cytotechs, gross room assistants, and transcriptionists. All of that is almost as rewarding as motherhood.

On the flip side, I have two good female friends who gave up after residency - one quit when she started having kids and is now a full time mom of four, and another quit soon into her life as a pediatric allergy-immunology attending, after doing a fellowship at a prestigious institution. The latter's second son required more attention due to developmental problems, and she decided that staying home was more important. She was at the top of our class; a quiet, humble, lightning smart, and incredibly beautiful former ballet dancer. I bump into her at the local pool during the summer. She hasn't changed, and she seems happy with her decision.

I don't think you can go wrong, either way. I think it took an incredible amount of soul-searching and selflessness for both of my friends to have given up their dreams for full-time motherhood. I respect the hell out of them. Both waited until after residency to make that decision, which I think is a smart thing to do, since residency is the place where you are working the hardest and have the least amount of control.

This really struck home to me. I feel like I spent every day of medical school wanted to quit and stay home with my then 4 year old and newborn boys. Now that I am in residency, I only feel like that 50-75% of the time.

I was incredibly blessed to take six months off during medical school for my maternity leave. I loved every day of those six months. Yes, being a stay at home mom is hard, and the thank-yous few and far between. But I honestly loved it.

The problem is, I actually do like medicine. Which, some days, surprises me.

The plan for me, once I'm finished with residency, is to work part time. I want to do medicine, but more than anything, I want to be a mom that is available and there for my children. Parttime seems the logical choice.

When I am home, I idealized being at work. When I am at work, I idealized being at home.

But not so much anymore.

I had one PGY3 baby, one fellowship baby, and one private practice baby. Each had their advantages and challenges.

The big advantage of kids in residency is that I got paid during my maternity leave. In the real world, if you don't work you don't get paid.

I figure if I find myself always wishing I were working a little less and a little more then the balance must be about right.

After my fellowship, I took 10 months off to be home with #1 and #2. I found myself working 20 hours a week for the preschool #1 attended. I figured I must want something to do.

So I found a private practice to join. I LOVE the grown-up company at work and the intellectual stimulation.

Honestly, I think that had I taken more time off I might have been so fearful about my knowledge base that I might have stayed away much longer or not returned at all. Sad thought since I love my chosen field.

Let me tell you what my mom says.

Mom says, "As a woman you may live for 80 years. That is a long time to do only one thing. So expect to do many things over your career. Just not always at the same time."

Just wanted to say thanks for the post, and the comments! I'm a pre-med student with a 3.5 year old and a 3 month old, and I've been a stay-at-home-Mom for 3.5 years now. I struggle daily, wondering if my love for medicine is somehow shortchanging my kids, and I'm glad I'm not the only one. The truth is, for me, I'm a MUCH better mother when I'm in school than when I'm not. I value each and every second I'm with my kids, rather than watch the minutes click on endlessly . Then again, I've only attended part time since my son was born 3 years ago. Next fall, when my daughter is one, I will start full-time in preparation for the MCAT's, and medical school, and while I'm so excited at the prospects, I'm terrified of leaving my kids all day. It's nice to see other Mothers struggle with the same question, and to come out successfully, on the other side.

I'm a fourth year general surgery resident with a 2.5 year old son (I had him during my first of two research years) Over the last year I have thought often of leaving residency. The main reason is that as my son has gotten older he now talks about the fact that I'm not around much, so it's clear that it does have an impact on him. If I'm home when he wakes up in the morning on a weekend, the first thing he asks me is whether I have to go to work. If I say no, he's so genuinely excited. It doesn't seem right. Sometimes a couple of nights go by and I can't make it home before he goes to bed. My schedule has also been very hard on my husband. There is no way around it. At the same time, I love what I do and have been at this for 5.5 years (including the research). It's hard to imagine quitting. At this point I just hope that I will make it through these next 18 months. I truly believe that it is possible to have a family and a rewarding medical (and yes surgical) career; but of course this requires finishing residency first! Good luck to you!

My mom was an investment banker and spent 80 hours a week at work until I was 5 and she was laid off (never went back). She tells me that I used to hang on her leg every morning and beg her to stay home with me, and that this made her feel terribly guilty.

You know what? I turned out fine. And she was a good mother.

Fundamentally (probably with some exceptions), the decision is about what YOU want to do, not whether you are somehow screwing your children by working a demanding job when they are little.

Original Poster here. First, thank you so much, KC, for making my comment a post. Second, I am so grateful for the comments. I find myself jealous of attending moms with part-time options. I have a dual-degree and a couple working years before that, so during med school was "time". I'm finding intern year challenging in terms of the time away. I imagine I would love it, if I did not feel so torn. I never tire of hearing the "my mom worked and I turned out fine" stories--they do buoy me. However, I also know that I will never get my baby time back and perhaps that is what saddens me. I have a top-notch residency spot, too, and I know if I walk away, it will be bye bye clinical career. It's just a tough choice...and eye opening to realize having it all means having less fulfillment on both sides, mixed in with feelings of being conflicted constantly.

Great idea about PT residencies. I have heard of people doing it. The arrangement I have heard that works best for the residency is to have the person on every other month. I suppose the best way to arrange this would vary among specialties.

I know some residencies can accommodate people who have medical issues, ie seizure disorders, where conventional overnight calls cannot be done.

I know quite a few people in Austrslia who job share in hospital jobs (not just General Practice) because of children or for other reasons (health, studying for exams, burn out, lifestyle, other interests etc). It doesn't seem to happen as much in surgery, but in everything else there is often some sort of part time option (obviously more when you have finished your postgraduate training). It might have something to do with the way our training programs (your "residency") are structured. Not saying it makes it easy at all though (particularly since I've never been in that situation).

I spent most of my first year back from my maternity leave wanting to quit... or at least, wishing residency could finally be over so that I could just stay home with my daughter.

Then when graduation from residency started to approach and I almost had what I always wanted, all I could think about was, "OMG, I need to have a job!" Now I'm a fellow and I would never ever be a SAHM. Once my schedule became reasonable, I realized that working makes me appreciate my time with my daughter even more. That said, I'm hoping for a job that will allow me to work only four days a week.

I'm from Australia and I know an Obgyn, a psychiatrist, an endocrinologist, a paediatrician and a pathologist who all managed to "job share" in their Registrar (like Resident) years. This essentially meant working half time. It took some negotiating, including finding someone willing to share the job with them, but they all managed it. Thye would work part of every week and share on call.I think we are slightly more flexible over here (Thankfully!), but also our training programs run for a longer time. It takes 6 full time years to qualify in OBGYN, I think it takes 5 for psychiatry etc. Maybe the length of training means that more flexibility is allowed.My intern year was in a hospital that discouraged overtime so I never worked more than 50hrs a week. Very early on I joined a GP (Family Medicine) program that allowed part time training, but I was finished all of that by the time I had children. I truly feel that part-timr work allows the best of both worlds, but I;m really sorry that this does not seem to be an option for you.Rebecca

I want to add my voice to the choir. Despite constant ambivalence, from my reading and my own experience, mothers and children benefit from the mother having meaningful, challenging, rewarding work. My mother left a career she loved to be home with her four children and then started graduate school in a completely different field when she was fifty. She tore herself up with guilt about not being full time at home, but she was so, so much calmer, happier and more fulfilled once she went back to school that I vowed I would never stay home full time, and I haven't. I thought that this was slightly shameful, and that my satisfaction in working was a guilty secret, until I stumbled across the book Juggling by Faye Crosby. She reviews all the evidence for and against mothers working outside the home, and provides a clear view of the many advantages of continuing to work, with full appreciation of difficulties.

Husbands and fathers are somewhat invisible or inaudible in this blog, but these decisions also involve them. My husband married my adult self, not my momself; I think that being a working mom may help a marriage. In our lives, my fairly demanding work meant that my husband had to step up and become an engaged father long before there was a soccer/basketball/swim team to coach. So the changes we experienced becoming parents were pretty much in sync, and have remained so now that the kids are fially grown.

Residency is not just a job, of course, and having very young children is especially demanding, but with the new work hour rules, and with most programs getting progressively more flexible as you move from pgy I to later years,thing really do improve. The baby years are precious, but the lovely moments don't accumulate-whether you have them every hour, every day, or only whenever you can, the memory fades as the children's later selves eclipse the earlier ones. Negotiate, adapt, be flexible, but don't do anything rash!

I'm really struggling. I have 2 years left in my residency, have a 8 month old daughter and am now 8 weeks pregnant (not planned!). My program is full of very nice people and because I transferred from a different res program and was already off cycle, I am able to take a nice long maternity leave. I have help taking care of the kids from my mom. My husband is in medicine and is an attending and we have plenty of money. I don't even have any debt, thanks to an amazing family. Everyone in my life is supportive of me doing what I need to do. I feel like I have so much going for me and I'm so so fortunate. Problem is, I just don't want to do this anymore. It's not just that I'm dying to be at home with my daughter and that she cries when I take her away from her grammy (which destroys me). Or that another baby is probably going to be too much for my mom to handle for the year (at that point) until I'm done. I was a yoga teacher before I went to med school, loved it, wanted to do an ND or ayurveda school, but it seemed better at the time to do an MD because I believed it was the best training I could get about the human body. I always thought I'd go back and do some hybrid of conventional and alternative medicine. But I got caught up in the excitement of the match, etc, and decided to do residency too, which I didn't really regret until I got pregnant with my daughter. Since then it's been a constant struggle and its getting worse internally I'm in turmoil. I'm actually a really good resident and most days I manage to do what's in front of me quite well, but I'm faking it, every day and it's starting to wear me out. I don't think I can do two more years. I really want to go back to teaching yoga and one day (when the kids are older) open up my own studio. The training will never hurt me. I'm just not sure sacrificing two more years is worth it, since I'm quite certain that I won't feel the nagging urge to go back to practice when the kids are older (I see myself in my studio, not in my office, later in life!) That being said, I'm not a quitter and I wince every time I think of letting down my fellow residents and PD. And I'm terrified I'll regret the choice I'm thinking of making. Any thoughts? Help!

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